Risks associated with red blood cell transfusions: potential benefits from application of pathogen inactivation

Kleinman, Steve; Stassinopoulos, Adonis

A lthough transfusion safety has increased greatly, risks are still associated with red blood cell (RBC) transfusion. These could be reduced if a robust technology was approved for pathogen inactivation of RBCs (PI-RBCs) by applying the PI technology either to the RBC component or to the parent whole blood (WB) unit. In a recent risk/benefit publication on PI platelets (PLTs) prepared using the Intercept system, 1 we emphasized that such an analysis should calculate benefits and risks on a per-patient rather than a per-unit basis. However, because this is a more difficult task for RBCs, we used a combined approach of calculating a risk per RBC unit and, when possible, a per-patient risk. Since the availability of PI-RBCs would result in the potential to transfuse a full complement of PI blood components (RBC, PLTs, plasma), we also discuss operational benefits that could be achieved under a full PI scenario.